Individual
MARK KNODLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1804 AMIS AVE, LAS CRUCES, NM 88005-1652
(575) 644-2624
Mailing address
1804 AMIS AVE, LAS CRUCES, NM 88005-1652
(575) 644-2624
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Enumeration date
12/30/2013
Last updated
12/30/2013
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